1. What makes asphyxia or breath control different from other autoerotic practices?

The short answer is the “fantasy” is the difference. I think it involves an aspect of “control”. A big part of the fantasy is the person’s control over their own death. It’s a bit “self-sacrificial”, a death fantasy, if you will. Not a wish to die, but a fantasy of death. Like a daredevil cheating death. Not far apart, in my opinion. Make sense?

I’ll take this opportunity to espouse my opinion on AeA vs. “Breath Control Play” (BCP). AeA is not the same as BCP. Many people confuse the two. AeA is a solo sexual practice with many unique characteristics that go beyond the euphoria of hypoxia. BCP is something that is mostly done among sexual partners to increase sexual pleasure with hypoxia. Enough said.

2. Why do you think people engage in breath control? How do you think they come to this practice?

(I’ll assume you mean AeA). This is a long, complicated and elusive answer. People engage in AeA because they quite simply have to. It becomes, for most, the only way they can “get off”. Even those that have sex with a partner most likely fantasize about AeA while engaging in normal sex. How they start, is a question that can’t be answered directly because it is a product of many variables in sexual development. My best guess from speaking to practicing AeA’ers is that they stumble onto hypoxia by accident or experiment and associate that with sexual arousal. Most in their early teens or pre-teen years. About half had experiences with other adult males in their lives. Not sexual experiences, but innocent games that become sexualized by the young one. Physiology plays an important role in this. Priapism is what happens when someone gets choked to hypoxia.

Here’s a scenario. A kid is playing cowboys and Indians with his uncle. The kid wants to be the bad guy and gets caught and tied up by the good guy. Kid gets and erection, likes it and wants to do it again. It gets elaborated over time and viola, AeA.

3. Do you think autoerotic breath control can be engaged in safely? What about breath control play with a partner?

Safety is a relative term. My answer is NO. BCP is safest, with a partner. AeA is solo and more dangerous. Even the most elaborate escape mechanism relies on the user’s judgment. Most are impaired by alcohol, which effects their judgment. It’s a fine line of consciousness. Lose it and you’re dead. The irony of this is that many have told me that the harder it is to escape, the better the fantasy is. **See death fantasy above.

All that is one aspect of safety. Then we get into physiological aspects. If you lose consciousness at the right phase of the sinus rhythm, your heart stops and can’t be restarted by CPR. This is the cause of many deaths when couples are engaging in BCP or when police use the choke hold and the suspect dies. Read the article on the internet called “The Medical Realities of Breath Control Play” for more detailed information. Written by a MD. I have it if you can’t find it.

4. What are the differences between adults who practice autoerotic asphyxia and adolescents who practice autoerotic asphyxia?

Elaboration. Kids experiment with it. Choking games. Most likely with a friend small group of friends. If it gets linked with sexual arousal and the personality is right, it gets elaborated over time. It becomes AeA, ritualistic and necessary for the practitioner. As adults progress with AeA, their appetite increases for more intense fantasies. This is where you may get clustering of paraphilias….bondage, cross-dressing. Things get complicated from there.

5. Why do you think more men engage in autoerotic asphyxia than women?

It’s biology. Simple? (Generally speaking, knowing there are exceptions) Men are visual in their stimulation. Women are emotional in their stimulation. AeA is a visualization of a scenario which brings sexual gratification. That’s why when a woman dies from AeA there are not always the tell-tale (Read: visual) signs of AeA behavior. It’s more in their head than on physical objects.

6. In what I have read, there seems to be a lot of mixed responses about families preferring to know that their son/daughter died in an autoerotic accident as opposed to suicide — that in some respects it is comforting to know they didn’t commit suicide. But, on the other hand some families seem to be ashamed that their son/daughter engaged in autoerotic behavior, and would rather inform outsiders that they committed suicide. What do you think about this split response?

I’ll give our experience as an example. We thought that is was easier to tell people that Bob committed suicide. That was because it was easier for others to understand. Think about it. We soon came to the conclusion that suicide made it easier for others to understand, however, it was not fair to Bob, nor was it fair to our family. He did not wish to die. He loved life and lived it fully. Ultimately, we placed Bob and family in front of other people’s “comforts of understanding”. The way it should be. Those that wanted to know, close family and select friends, we told them what happened. We tried to explain AeA as best we could. Most often, it was not important if they understood, only that they knew the truth. In the long run, our family decisions were the best.

7. In the case of an autoerotic death — if the death is ruled as such, as opposed to suicide, does and will insurance companies compensate surviving family members?

They should, but some don’t. They put up a fight. It all stems from the police report and the coroner (ME) report. In our case there was no question and the insurance benefit was paid. I know the police detectives wrote the report so there was no question. I am thankful for that.

8. Do you think that people who currently practice asphyxia, either alone or with a partner, should be encouraged to stop? If so, how do you propose that they are encouraged to stop?

AeA is dangerous (see above) and those doing it should stop. Different therapies have been used to varying degrees of success. Saratonin replacement, behavioral modifications and others have been tried. The bottom line is that AeA’ers may always have the fantasies but they may not always act on them. It’s a behavior that can be controlled if the desire is strong enough. Last point being key….they have to want to stop. Most really don’t.

9. What do you think can be done to prevent people from engaging in asphyxia?

Educating people on the dangers of hypoxia and ligature strangulation. Death is a strong deterrent, right?

10. What advice would you give to family members who discover that their brother/sister/son/daughter is regularly engaging in autoerotic asphyxia — they aren’t sure how to handle the situation and they have solicited your advice?

Seek professional help and be supportive. Learn about AeA so they can identify with what the person is going through.